Saturday, April 10, 2010

Casual lunch conversation about VBAC and government intrusion

I had a casual conversation with my boss the other day about my class and interests in public health and childbirth. (For any readers who don't know me personally, I do not currently work in an area related in the least to public health.) Well, we got talking and before I knew it I was letting loose all my favorite appalling statistics about childbirth in the US. Yes, I said the word "vaginal" to my very male, very straight-laced boss, and the heavens did not come crashing down. I was proud of myself. I'm always nervous that if I start talking about this stuff I am going to weird people out. He did ask the source of my interest, and when I said "I'm not pregnant" we both laughed - three other co-workers just returned from their maternity leaves, so it is baby season at my office. He also told me his sister used to work at Yale in their Nurse-Midwifery program! How cool is that?

I also talked about the basic idea that we tend to think of individuals as being responsible for or capable of controlling their own health outcomes, though research shows that this often isn't the case. He objected strongly to the claim that the government has a place in issues of say, childhood obesity - for him, it is solely the parents' job to deal with their children's health. He is devoutly Libertarian. I had to admit to myself after the conversation that I have not spent enough time thinking about the idea that it is a political belief that government should care for its citizens in the way that public health often advocates. Is it possible to be on the right-wing, less-government side of things and be an advocate for public health? I feel like my thinking on this issue is so simplistic as to be laughable. I guess it will have to come with time and a better understanding of what roles the US government does and does not actually play on public health issues.

When we were talking about childhood obesity, I pointed out that lower-income neighborhoods often have a paucity of accessible supermarkets with reasonably-priced and appealing produce sections. He argued that the market would take care of that, and if it were the case that people would buy the produce, the stores would have it. That seemed all wrong, but I didn't have a rebuttal until the next week, when attending the kick-off breakfast for the annual Project Bread Walk for Hunger. One of the speakers was Lauren A. Smith, who is the Medical Director of the Massachusetts Department of Public Health. She was explaining how hunger and obesity often go hand-in-hand in communities. I don't have the exact quote, but she said that fast food is the economically smart choice for people who are struggling with hunger. Fast food is often extremely calorie-dense - a lot of calories not only per gram, but per dollar. When your first priority is eating at all, it only makes sense to get as many calories per dollar as you can - and an apple does not fit that bill.

I leave you with two awesome links:
Maybe this is part of the problem/solution?
And as much as I roll my eyes about not eating "weird chemicals that should never be in food zomg?!?!?", this is disturbing.